Disease: Juvenile idiopathic arthritis

Overview

Juvenile idiopathic arthritis, formerly known as juvenile rheumatoid arthritis, is the most common type of arthritis in children under the age of 16.

Juvenile idiopathic arthritis can cause persistent joint pain, swelling and stiffness. Some children may experience symptoms for only a few months, while others have symptoms for the rest of their lives.

Some types of juvenile idiopathic arthritis can cause serious complications, such as growth problems, joint damage and eye inflammation. Treatment focuses on controlling pain and inflammation, improving function, and preventing joint damage.

Source: http://www.mayoclinic.com

Symptoms

The most common signs and symptoms of juvenile idiopathic arthritis are:

  • Pain. While your child might not complain of joint pain, you may notice that he or she limps — especially first thing in the morning or after a nap.
  • Swelling. Joint swelling is common but is often first noticed in larger joints such as the knee.
  • Stiffness. You might notice that your child appears clumsier than usual, particularly in the morning or after naps.
  • Fever, swollen lymph nodes and rash. In some cases, high fever, swollen lymph nodes or a rash on the trunk may occur — which is usually worse in the evenings.

Juvenile idiopathic arthritis can affect one joint or many. There are several different subtypes of juvenile idiopathic arthritis, but the main ones are systemic, oligoarticular and polyarticular. Which type your child has depends on symptoms, the number of joints affected, and if a fever and rashes are prominent features.

Like other forms of arthritis, juvenile idiopathic arthritis is characterized by times when symptoms flare up and times when symptoms disappear.

When to see a doctor

Take your child to the doctor if he or she has joint pain, swelling or stiffness for more than a week — especially if he or she also has a fever.

Source: http://www.mayoclinic.com

Causes

Juvenile idiopathic arthritis occurs when the body's immune system attacks its own cells and tissues. It's not known why this happens, but both heredity and environment seem to play a role. Certain gene mutations may make a person more susceptible to environmental factors — such as viruses — that may trigger the disease.

Source: http://www.mayoclinic.com

Diagnosis

Diagnosis of juvenile idiopathic arthritis can be difficult because joint pain can be caused by many different types of problems. No single test can confirm a diagnosis, but tests can help rule out some other conditions that produce similar signs and symptoms.

Blood tests

Some of the most common blood tests for suspected cases include:

  • Erythrocyte sedimentation rate (ESR). The sedimentation rate is the speed at which your red blood cells settle to the bottom of a tube of blood. An elevated rate can indicate inflammation. Measuring the ESR is primarily used to determine the degree of inflammation.
  • C-reactive protein. This blood test also measures levels of general inflammation in the body but on a different scale than the ESR.
  • Anti-nuclear antibody. Anti-nuclear antibodies are proteins commonly produced by the immune systems of people with certain autoimmune diseases, including arthritis. They are a marker for an increased chance of eye inflammation.
  • Rheumatoid factor. This antibody is occasionally found in the blood of children who have juvenile idiopathic arthritis.
  • Cyclic citrullinated peptide (CCP). Like the rheumatoid factor, the CCP is another antibody that may be found in the blood of children with juvenile idiopathic arthritis.

In many children with juvenile idiopathic arthritis, no significant abnormality will be found in these blood tests.

Imaging scans

X-rays or magnetic resonance imaging (MRI) may be taken to exclude other conditions, such as fractures, tumors, infection or congenital defects.

Imaging may also be used from time to time after the diagnosis to monitor bone development and to detect joint damage.

Source: http://www.mayoclinic.com

Complications

Several serious complications can result from juvenile idiopathic arthritis. But keeping a careful watch on your child's condition and seeking appropriate medical attention can greatly reduce the risk of these complications:

  • Eye problems. Some forms can cause eye inflammation (uveitis). If this condition is left untreated, it may result in cataracts, glaucoma and even blindness.

    Eye inflammation frequently occurs without symptoms, so it's important for children with this condition to be examined regularly by an ophthalmologist.

  • Growth problems. Juvenile idiopathic arthritis can interfere with your child's growth and bone development. Some medications used for treatment, mainly corticosteroids, also can inhibit growth.

Source: http://www.mayoclinic.com

Lifestyle and home remedies

Caregivers can help children learn self-care techniques that help limit the effects of juvenile idiopathic arthritis. Techniques include:

  • Getting regular exercise. Exercise is important because it promotes both muscle strength and joint flexibility. Swimming is an excellent choice because it places minimal stress on joints.
  • Applying cold or heat. Stiffness affects many children with juvenile idiopathic arthritis, particularly in the morning. Although some children respond well to cold packs, most children prefer a hot pack or a hot bath or shower.
  • Eating well. Some children with arthritis have poor appetites. Others may gain excess weight due to medications or physical inactivity. A healthy diet can help maintain an appropriate body weight.

    Adequate calcium in the diet is important because children with juvenile idiopathic arthritis are at risk of developing weak bones (osteoporosis) due to the disease, the use of corticosteroids, and decreased physical activity and weight bearing.

Source: http://www.mayoclinic.com

Coping and support

Family members can play critical roles in helping children cope with their condition. As a parent, you may want to try the following:

  • Treat your child, as much as possible, like other children in your family.
  • Allow your child to express anger about having juvenile idiopathic arthritis. Explain that the disease isn't caused by anything he or she did.
  • Encourage your child to participate in physical activities, keeping in mind the recommendations of your child's doctor and physical therapist.
  • Discuss your child's condition and the issues surrounding it with teachers and administrators at his or her school.

Source: http://www.mayoclinic.com

Risk factors

Some forms of juvenile idiopathic arthritis are more common in girls.

Source: http://www.mayoclinic.com

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